The deltoid muscle is situated around the shoulder joint that makes up the shoulder. It is classified into three parts - front, side and rear deltoids. It is one of the most frequently used muscles in the body, its major functions are abduction and forward elevation of the arm.

Causes
A deltoid strain is a condition where you experience pain and tenderness in the shoulder area due to various causes like overuse of the deltoid muscle. It is very common in weightlifting and various sports such as cricket. It may even lead to partial loss of function in the deltoid muscle. Deltoid strain may be caused due to overworking of the muscle without adequate rest. It may also be caused due to lengthening of the deltoid muscle under stress or direct trauma to the muscle.

There are three types of deltoid strains

Grade 1 deltoid strain: It is characterized by tight muscles with some possible swelling. There may be mild pain when you use your shoulders for any activity.
Grade 2 deltoid strain: This strain is a result of a major injury to the deltoid muscle; there may be visible swelling and pain while carrying out activities that require movement of the shoulder. Lifting your arm to the front or the sides becomes difficult and painful.
Grade 3 deltoid strain: This form of deltoid strain is the most severe of the three; it may cause the shoulders to become immobile. You usually will experience excessive pain and severe swelling. You might not be able to move your arm and carry out any activity that requires the shoulders.
Diagnosis
The diagnosis of a deltoid strain starts with a physical exam where the doctor will understand the symptoms of the deltoid strain. Various imaging tests such as x-rays may be required for the diagnosis. The basic treatment for shoulder strain comprises of the RICE protocol (rest, ice, compression and elevation) which is used to treat grade 1 and grade 2 strains. Grade 3 strains may require surgery in addition to the above treatment methods. In case of excess pain, the doctor may prescribe non-steroidal anti-inflammatory drugs to ease the pain.

All About Deltoid Strain!

Three Ways to Protect Your Knees

The knee is known as the largest and one of the most complex joints in the human body, and also one of the most vulnerable, as it supports the weight of the entire body. The knee joint is made up of several elements including the knee cap, meniscus, connective tissue, tendons, ligaments, cartilage, and muscles. Damage to any part of the knee can cause chronic pain. So how can you protect your knee from damage and injury? Take a look at these three points!

Dealing with Load: Weight is a big one. Carrying around extra pounds and kilograms can be detrimental for your knees in the long run. Your knee is not equipped to handle the excessive weight. It already supports three to five times your weight when you get up and walk around or indulge in some mild jogging. One must be careful of those extra pounds to take the load off the knee and keep it from falling prey to damage.

Exercise: Moderate to intense exercise is prescribed for one and all. This, of course, depends on one's overall health and age. If you are already suffering from joint pain, then you may want to go easy on the exercise with a focus on building muscle strength and foundation. If you are healthy, then some amount of daily exercise as a routine will keep those knees in prime working condition and well lubricated as well. Inactivity and a sedentary lifestyle can affect the knees very badly.

Do not Ignore: Warning signals such as chronic or acute knee pain should not be ignored. Remember to see a doctor or an orthopaedic specialist to find out if you have contracted an infection or if you may have suffered a fracture due to an injury. Also, it is important to take a bone density test regularly, especially after the age of 40 or for women going through menopause, as this will point to any deficiencies and even warn you in case there is any trace of osteoporosis.

Rest, exercise, and food should be kept in fine balance for a healthy body. These are a few measures that one can take to keep knee pain at bay. Yet, it is also advisable to speak with a doctor at length regarding measures to protect your knees.

Remember to ask us for a private consultation today!

Three Ways to Protect Your Knees

The trapezius muscle is a triangular muscle which extends from the neck, down to the middle of the upper back and across the shoulder. It is one of the largest muscles in the body. It helps in stabilizing and moving the scapula. When you rotate your neck, move your arms, or even shrug your shoulders, you are able to do it because of the trapezius muscle. Over use of the muscle can cause it to strain.

Trapezius strain can be quite annoying and uncomfortable as you will have difficulty in moving your shoulders. It also causes any upper shoulder movement very difficult as it gives out an excruciating pain whenever you try to move your head or rotate your neck. It generally happens when you repetitively put stress on the muscle.

Causes:
1. Poor posture while sitting, standing or lying down
2. If you sleep in a wrong or uncomfortable position
3. If you bend over a desk for hours(This is more relevant to office workers)
4. If you have to carry heavy weights on your shoulders(This is relevant to school and college students who have to carry heavy bags every day)
5. If you over work your trapezius during work outs
6. If you suddenly twist your neck
7. If you met with a fall or accident which injured your back.

Symptoms:
The symptom that characterizes a trapezius strain is the searing pain in the muscles which is scattered around from the shoulders to the neck. The pain might interfere in your daily activities such as moving your arms when you push or pull. It might also cause discomfort while trying to sleep. A trapezious strain might even cause a bit of swelling in the muscle. Sometimes, due to the neck pain, you might even get headaches.

Treatment:
1. Resting: Rest as much as possible. Any strain or swelling can be easily cured with proper rest.
2. Ice packs: Ice packs help to reduce the swelling and get some relief from the pain.
3. Exercise: Stretchingthe muscle will help loosen it.
4. Blood flow stimulation therapy: After the inflammation is reduced, you should take up this therapy as an increase in the blood flow in the affected area will help cure the strain.
5. Care for the scar tissue: The scar tissue will take longer to heal than the muscle. Hence you have to follow your doctor's instruction very carefully to get a speedy recovery.

All About Trapezius Strain!

The bones are the bits and pieces which form the framework of the body. Each bone is placed in the correct position to give your body the structure it has. It is of utmost importance for you to have healthy bones so that the structure or frame of your body is maintained. A lot of times, due to the stress of your daily life, you tend to neglect the health of your bones. But remember that if you want to have a fit body, you will have to keep your skeletal system fit as well. Here are a few tips on how to keep your bones healthy:

1. Family history: Having a knowledge of your family history is extremely important as there may be cases where you might suffer from a particular disease which is hereditary. If your family has a history of osteoporosis, there is a high chance of you suffering from it. 

2. Increase your regular calcium and vitamin D intake: Calcium is extremely essential for your bone health. If you want your bones to be healthy and strong, you need to take a regular calcium dose in order to achieve that. But there is a catch to this. Although you might have food containing calcium every day or take calcium tablets, it won't be helpful until you also get a supply of Vitamin D. Vitamin D helps the bones to absorb the calcium.

3. Maintain a healthy bone density: To do this you need to eat food which will supply you with vitamin K. Vitamin K boosts bone density by enabling the body to make proteins required for healthy bones. Vitamin K also helps the bones absorb calcium just like vitamin D although this function is not predominant for vitamin K.

4. Exercise: The secret to healthy bones is exercise. The more you exercise regularly, the fitter your bones and muscles will be. Regular exercise helps to keep bone problems at bay. Leading a sedentary lifestyle heightens the risk of suffering from osteoporosis. It can also mess with your bone density and weaken your bones. Hence, exercise regularly for healthy bones.

5. Cut down on your caffeine intake: Too much of caffeine can mess up the calcium absorbing power of your bones. If you have more than two cups of coffee every day, your bones will gradually become weak.

So, if you want to remain as fit as a fiddle, then try these tips out, and you will not complain.

Tips And Tricks To Keep Your Bones Healthy!

Spondylosis is a disease of the bone which involves wear and tear of the discs. The latter is the cushion between the joints of the neck and the neck bone. While it is mostly observed in aged people, it is not too uncommon among the youth as well. It can present with symptoms such as numbness, neck pain, headache, stiffness near the shoulder area etc. Ayurvedic treatment has been extremely promising in treating both cervical and lumbar spondylosis.

The food connection: Ayurveda states that there is a close connection between Spondylosis and food. In Ayurvedic terms, an increase of Vata Dosha can lead to the problem of Spondylosis. For instance, consumption of frozen or processed food, sodas, junk food, low consumption of water, excess consumption of curried food heighten the chances of Spondylosis.

Habits matter: As per the books of the Ayurveda, a reckless lifestyle increases the chances of Spondylosis. Habits such as day sleep, regular walking for a long distance, urging the suppression, rigorous exercise daily, work that involves bearing of weight on the neck, head and shoulder, night awakening etc. can wreak havoc and result in Spondylosis. On the other hand, healthy lifestyle changes can help a person refrain from this condition.

Psychological Factors: Ayurveda states that even psychological factors can go a long way in making a person suffer from Spondylosis. Certain factors such as excess stress, loss of interest in day to day work, fear of failure, feeling of frustration, too much anger, grief resulting from personal loss etc. play a major role in Spondylosis.

Visible Symptoms of Spondylosis:
Some medical symptoms that can be easily identified as the signs of Spondylosis include fatigue, pain in the arm, shoulder, and forearm, difficulty in functions pertaining to neck rotation, extension, joint stiffness, muscular spasm, headache, weakness in the arm, difficulty in movement, difficulty in muscle coordination etc.

Some ayurvedic treatments to deal with Spondylosis

Treatment: 

Home Remedies For Cervical Spondylosis:

Use Cow's ghee in your food. It is a best natural "Vata" reliever and gives nourishment to the nerves and other body parts.

1 tablespoonful of Turmeric should be consumed once every day, after boiling it in milk for half an hour. It is a very useful herbal treatment for cervical Spondylosis.

Constipation must be avoided at all costs. Constipation may increase pain in Cervical Spondylosis.

Herbs have divine healing powers and they have the ability to cure any type of disease from the root. They were gifted to us by God when he created life. So believe in God if you want to get rid of your problems!

Ayurvedic herbs are unique natural remedies for Cervical Spondylosis. Ayurvedic principles are different in many ways from modern medicine for example - Drinking water from a copper pan after keeping it overnight is also very useful in Rheumatoid arthritis and Cervical Spondylosis.

Consuming castor oil at night with milk or alone is a very useful herbal remedy for arthritis, especially rheumatoid arthritis and Cervical Spondylosis.

Improve your nutrition as the first step.It plays an important role to fight diseases. When nothing works, nutrition does!

Use herbal juices like Aloe vera juice (Kumari Saar) and Amla Juice (Amla Saar) in routine. Amla is the richest source of natural Vitamin C. Vitamin C improves the natural immunity of the body. 100 gm of Amla juice contains 30 times more vitamin C than 100 gm of oranges.

Greeva Basti- A compound created with Bala Ashwagandhadi oil, Medicated oil and black gram paste is applied on the affected area. Regular application of this can regenerate the muscle bone and reverse Spondylosis to a considerable extent.

Ayurvedic Herbs For Spondylosis
Some ayurvedic herbs are known to be extremely beneficial for treating Spondylosis. When these are consumed or applied on the affected area, they can fetch surprising result for a Spondylosis patient. Some of these herbs include Prishniparni (Uraria picta), Ashwagandha (Withania somnifera), Guggulu (Commiphora mukul), Shunthi (Ginger), Bala (Sida cardifolia), Amalaki (Emblica officinalis), Gambhari (Gmelina arborea), Shallaki (Boswelia serrata), Rasna (Pluchea lanceolata), Castor root (Ricinus communis) etc.

Spondylosis - Is Ayurveda The Best Form Of Treatment?

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

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